Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Prognostic Value of Dual-Energy CT-Based Iodine Quantification versus Conventional CT in Acute Pulmonary Embolism: A Propensity-Match Analysis

  • Dong Jin Im (Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine) ;
  • Jin Hur (Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine) ;
  • Kyunghwa Han (Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine) ;
  • Young Joo Suh (Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine) ;
  • Yoo Jin Hong (Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine) ;
  • Hye-Jeong Lee (Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine) ;
  • Young Jin Kim (Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine) ;
  • Byoung Wook Choi (Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine)
  • Received : 2019.08.28
  • Accepted : 2020.03.09
  • Published : 2020.09.01
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Abstract

Objective: The present study aimed to investigate whether quantitative dual-energy computed tomography (DECT) parameters offer an incremental risk stratification benefit over the CT ventricular diameter ratio in patients with acute pulmonary embolism (PE) by using propensity score analysis. Materials and Methods: This study was conducted on 480 patients with acute PE who underwent CT pulmonary angiography (CTPA) or DECT pulmonary angiography (DE CT-PA). This propensity-matched study population included 240 patients with acute PE each in the CTPA and DECT groups. Altogether, 260 (54.1%) patients were men, and the mean age was 64.9 years (64.9 ± 13.5 years). The primary endpoint was all-cause death within 30 days. The Cox proportional hazards regression model was used to identify associations between CT parameters and outcomes and to identify potential predictors. Concordance (C) statistics were used to compare the prognoses between the two groups. Results: In both CTPA and DECT groups, right to left ventricle diameter ratio ≥ 1 was associated with an increased risk of all-cause death within 30 days (hazard ratio: 3.707, p < 0.001 and 5.573, p < 0.001, respectively). However, C-statistics showed no statistically significant difference between the CTPA and DECT groups for predicting death within 30 days (C-statistics: 0.759 vs. 0.819, p = 0.117). Conclusion: Quantitative measurement of lung perfusion defect volume by DECT had no added benefit over CT ventricular diameter ratio for predicting all-cause death within 30 days.

Keywords

References

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